p53 protein expression in squamous cell carcinoma of the vulva

BACKGROUND. The objective of the study was to evaluate the pathogenetic and prognostic value of p53 protein expression in squamous cell carcinoma of t he vulva. METHODS. The clinical data in charts of 167 patients with International Fed eration of Gynecology and Obstetrics (FIGO) Stages I-III primary tumors who were treated by surgery were reviewed. Samples from the primary tumor were immunostained for p53 protein, p53 overexpression was defined as immunorea ctivity in > 5% of nuclei. RESULTS. p53 overexpression was observed in 92 tumors (55%). p53 overexpres sion did not correlate with age at diagnosis, FIGO stage, histologic grade, Vessel invasion, tumor thickness, tumor greatest dimension, DNA ploidy, or inguinal lymph node metastasis. In the whole group a significantly reduced 5-year corrected survival was observed in patients with p53 overexpression compared with p53 negative patients (P = 0.04). In the different FIGO stag es, disease-related survival was not influenced by p53 overexpression in 37 patients with Stage I disease (P = 0.60) or in 86 patients with Stage II d isease (P = 0.96). In 44 patients with Stage III disease, p53 overexpressio n was significantly associated with poorer prognosis (P = 0.004). Independe nt prognostic factors for corrected survival in the entire group of 167 pat ients were: Vascular invasion, groin metastasis, tumor greatest dimension, and p53 overexpression. In patients with FIGO Stage III disease p53 overexp ression was not an independent prognostic factor. CONCLUSIONS. p53 protein overexpression appears to be involved in the patho genesis of vulvar squamous cell carcinoma. p53 protein overexpression was s ignificantly associated with disease-related survival. p53 prognostic impac t was observed only in patients with advanced disease. Cancer 1999;85:1133- 8. (C) 1999 American Cancer Society.